Ear

Question 1

What is the gender bias associated with excessive ear wax?

Answer 1

Males

Question 2

What is a Rinne negative finding?

Answer 2

Sound heard longer through bone than air (significant canal or middle ear problem)

Question 3

What is the most common cause of otitis externa?

Answer 3

Bacterial infection

Question 4

Are all middle ear fluids infected and/or painful?

Answer 4

NO

Question 5

What is the Rinne test for presbycusis?

Answer 5

Air conduction is greater than bone conduction but less than the 2:1 ratio

Question 6

What causes cholesteatomas?

Answer 6

Congenital defects, chronic otitis media and perforations

Question 7

Suppurative otitis media is common among what age group?

Answer 7

Children 6 months to 6 years old

Question 8

If one ear is affected by otosclerosis, what will be the findings of the “finger rustle”, Weber, and Rinne tests?

Answer 8

“finger rustle” - diminished on that side Weber - lateralization on that side Rinne - air will be less than bone

Question 9

What is a Rinne positive finding?

Answer 9

Air is heard twice as long as bone

Question 10

Why does sound lateralize to the ear with a significant canal or middle ear problem during the Weber test?

Answer 10

Sound cannot escape the ear therefore rebounding it back to the inner ear for a double dose of sound

Question 11

What color is the eardrum?

Answer 11

Pearly gray

Question 12

What is the shape of the tympanic membrane?

Answer 12

Concave

Question 13

What is the most painful cause of otitis externa?

Answer 13

Bacterial infection

Question 14

What is different with the main symptoms of otitis externa caused by bacteria compared to fungi?

Answer 14

Bacteria = pain Fungi = itching

Question 15

What is usually the cause of a bloody effusion in the middle ear?

Answer 15

Temporal bone fractures or shearing force causing mucosal bleeding

Question 16

What is the issue with cholesteatomas?

Answer 16

Erodes surrounding bone and ossicles therefore able to cause hearing loss

Question 17

Blood vessels in what part of the tympanic membrane overlying the malleus are usually normal findings?

Answer 17

Pars flacida

Question 18

What kinds of things can cause tinnitus?

Answer 18

1 skull fracture 2 closed head injury 3 whiplash injury 4 TMJ disorders

Question 19

What is the supposed general cause of labyrinthitis?

Answer 19

Viral infection

Question 20

What is the name for the triangular reflection of light from the otoscope seen on the tympanic membrane?

Answer 20

Light reflex

Question 21

What ossicle creates the landmarks of the tympanic membrane?

Answer 21

Malleus

Question 22

What will be the finding of the Rinne test if there is a total sensorineural loss of hearing?

Answer 22

Nothing will be heard by air nor bone

Question 23

The auditory (Eustachian) tube joins what two structures?

Answer 23

Nasopharynx to middle ear

Question 24

What are symptoms of inner ear problems?

Answer 24

Vertigo (nausea), tinnitus, sensory hearing loss

Question 25

What is the condition where white calcium patches are present on the eardrum resulting from old eardrums perforations?

Answer 25

Tympanosclerosis

Question 26

When must the Rinne test be performed?

Answer 26

If Weber test lateralizes

Question 27

What fills the tympanic cavity?

Answer 27

Air

Question 28

What is the color of fresh earwax? Of old and built up earwax?

Answer 28

Fresh = honey-colored Old = dark black

Question 29

What does the Rinne test compare?

Answer 29

Air to bone conduction

Question 30

Where is the tympanic cavity located?

Answer 30

Carved in the temporal bone

Question 31

Where do we find the cerumen glands?

Answer 31

Outer 1/3 of the canal

Question 32

What are the two divisions of the tympanic membrane?

Answer 32

Pars flacida (attic) Pars tensa (lower 2/3)

Question 33

What happens to the patient when the eardrum perforates?

Answer 33

Discharge into canal and immediate end of earache

Question 34

What are the two possibles problems if lateralization is found in the left ear during the Weber test?

Answer 34

1 sensorineural loss in the right ear 2 air conduction problem in left ear

Question 35

What is another name for the tympanic membrane?

Answer 35

Eardrum

Question 36

What is the clinical term for inflammation of the inner ear and its nerves?

Answer 36

Labyrinthitis

Question 37

What tool can be used to assess for sensorineural problems or middle ear problems unable to be seen on the eardrum?

Answer 37

Tuning fork

Question 38

If a patient hesitates to answer which ear they hear better in during the Weber test, what is to be expected?

Answer 38

Normal response (no issues)

Question 39

What things can cause otitis externa?

Answer 39

1 bacteria 2 fungi 3 swimming 4 dermatitis/psoriasis may contribute

Question 40

Which test involves a vibrating fork being places in the midline of the head and asking the patient which ear they hear the ringing better in?

Answer 40

Weber test

Question 41

What is exostosis?

Answer 41

Abnormal, benign, boney growth of the temporal bone that protrudes into the canal

Question 42

What is the number one reason for sensorineural hearing loss? Number two?

Answer 42

#1 = age-related hearing loss (presbycusis) #2 = noise-induced hearing loss

Question 43

What is the Rinne finding with noise-induced hearing loss?

Answer 43

Air conduction is greater than bone conduction but less than the 2:1 ratio

Question 44

What is otosclerosis?

Answer 44

Abnormal ossification of the ossicles

Question 45

How does fresh earwax naturally get pumped out of the ear?

Answer 45

TMJ

Question 46

What is the clinical term for "swimmer's ear"?

Answer 46

Otitis externa

Question 47

What three tests check for cranial nerve VIII?

Answer 47

1 "finger rustle" 2 Weber test 3 Rinne test

Question 48

If during the Rinne test, air conduction is greater than bone conduction but not by 2X, what is the problem?

Answer 48

Inner ear (sensorineural loss)

Question 49

What is the treatment for eardrum perforations?

Answer 49

Small ones heal on their own Large ones might need to be patched up surgically

Question 50

Tinnitus affects roughly what percentage of the U.S. population?

Answer 50

10%

Question 51

What is probably the most common occupational and environmental hazard?

Answer 51

Noise

Question 52

Disorders of what other areas besides the inner ear can also cause vertigo?

Answer 52

Vestibular nerve, brainstem, cerebellum

Question 53

What does the middle ear consist of?

Answer 53

1 eardrum 2 tympanic cavity 3 ossicles

Question 54

Which ossicle is most likely to be affected by otosclerosis?

Answer 54

Stapes (fixation to the oval window)

Question 55

What is the appearance of mucus in the middle ear?

Answer 55

Thick, viscous, darker than normal

Question 56

What are the three possible mechanisms for auditory tube blockage?

Answer 56

1 barotrauma 2 adenoidal hypertrophy 3 URTI or allergy causing lumen occlusion

Question 57

When does otosclerosis most commonly occur?

Answer 57

Between ages 11-30

Question 58

What specific sounds are lost first followed noise-induced hearing loss?

Answer 58

High frequency sounds (3000 to 6000 Hz)

Question 59

What are the functions of earwax?

Answer 59

1 produce acidic coat that inhibits bacterial and fungal growth 2 prevents water from entering skin due to hydrophobic nature

Question 60

Antibiotic treatment has been shown to have little benefit in which kind of earache cases?

Answer 60

Otitis media without fever

Question 61

What are things that increase the chances of getting middle ear effusions?

Answer 61

1 crowded child care facilities (increased URTIs) 2 secondhand smoke 3 bottle-fed infants

Question 62

What is the term for age-related hearing loss?

Answer 62

Presbycusis

Question 63

What are cystic masses composed of epithelial cells and cholesterol found in the middle ear called?

Answer 63

Cholesteatomas

Question 64

What is the conventional treatment for middle ear effusions from the CDC?

Answer 64

WASP prescription (wait and see for 24 hours)

Question 65

What are the 3 ossicles?

Answer 65

Malleus, incus, and stapes

Question 66

Is hearing impaired in cases of serous fluid or mucus buildup in the middle ear?

Answer 66

Yes because ossicles can't conduct sound vibrations as well

Question 67

How does tympanosclerosis affect the patient?

Answer 67

If just on the eardrum - no issues If on ossicles - diminished hearing

Question 68

Patients with seborrhea or eczema are at risk for what kind of ear problem?

Answer 68

Otitis externa

Question 69

Which form of conduction should be more efficient: air or bone?

Answer 69

Air

Question 70

What is the name of the handle portion of the malleus which angles posteriorly?

Answer 70

Long process (manubrium)

Question 71

What is the color of sterile serous fluid that can build up in the middle ear?

Answer 71

Yellow

Question 72

What are the Weber and Rinne findings for suppurative otitis media?

Answer 72

Weber - lateralizes to affected side Rinne - negative on affected side

Question 73

How long do tympanostomy tubes stay in the eardrum before they are dislodged into the canal?

Answer 73

6-12 months

Question 74

The Weber test is an example of what kind of conduction pathway/

Answer 74

Bone (traveling through cranial bones, skipping canal and middle ear)

Question 75

What is the name of the rounded part of the malleus at the interface of the pars flacida and tensa?

Answer 75

Short process

Question 76

What is the gender bias for otosclerosis?

Answer 76

Females 2X (worse during pregnancies)

Question 77

During Dr. Fallon's study on patients with otitis media, which part of the body was found to almost always be sublimated on the side of the condition?

Answer 77

Occiput

Question 78

Is labyrinthitis painful?

Answer 78

No, rarely

Question 79

What actions can aggravate otitis externa?

Answer 79

Chewing, pressing on trague, wiggling auricle

Question 80

How can foreign objects affect the ear?

Answer 80

1 inflammatory 2 decreased hearing

Question 81

What motion of the auricle produces the best view with the otoscope due to the hilly nature of the canal?

Answer 81

Pull auricle up and backward

Question 82

What is the normal range for the "finger rustle" test?

Answer 82

2 ft

Question 83

When the auditory tube becomes occluded, what happens that causes the earache itself?

Answer 83

Trapped air gets resorbed which causes retraction of the eardrum

Question 84

Which four fluids have the potential to accumulate in the middle air following an occlusion of the auditory tube?

Answer 84

1 pus 2 serous fluid 3 mucous 4 blood

Question 85

What should be the findings of a normal Rinne test?

Answer 85

Air conduction should be 2X longer than bone conduction

Question 86

Presbycusis usually affects what group of people?

Answer 86

Elderly

Question 87

At what point are tympanostomy tubes recommended?

Answer 87

Recurrent infections (3 episodes in 6 months) Persistent fluid (3 months with hearing loss and unresponsive to antibiotics)

Question 88

What signs may be present in the ear in someone with serous fluid buildup in the middle ear?

Answer 88

1 yellow eardrum 2 air bubbles 3 fluid lines

Question 89

Which direction does the umbo face?

Answer 89

Backward

Question 90

What anatomical issue causes middle ear problems?

Answer 90

Blockage of the auditory tube

Question 91

If during the Rinne test, bone conduction is greater or equal to air conduction on the side of lateralization, what is the problem?

Answer 91

Canal or middle ear problem

Question 92

What is the issue with excessive earwax?

Answer 92

Can become impacted against eardrum and lead to decreased hearing

Question 93

What are the 4 major red flags of ear conditions?

Answer 93

1 sudden or rapid hearing loss 2 vertigo 3 unilateral tinnitus 4 bleeding due to foreign object or pressure change injury